NPI | 1770168981 |
---|---|
Former Name | MEREDITH SIMPSON BURBANK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209022581) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041486987) |
Enumeration Date | 2021-03-10 |
Last Update Date | 2022-12-09 |